271. Human Factors Engineering Approach, including Observations and Contextual Enquiry, to Improve Patient Room Cleaning.
Session: Poster Abstract Session: HAI: Environment and Device Cleaning
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • EVS 10 24 postrer Final pptx.pdf (707.2 kB)
  • Background: A clean patient environment is important to prevent transmission of multidrug resistant organisms in the hospital. Patient room cleaning is often performed inadequately. We apply a Human Factors Engineering (HFE) approach and collect different types of data, including observations, semi-structured interviews, and focus groups with environmental care associates (EVCA) to identify failure modes in the room cleaning process and potential solutions to improve room cleaning. Here, we present the observation data on daily cleaning.

    Methods: An observation tool was developed by a transdisciplinary team, including HFE, hospital epidemiologists, infection preventionists, and a front line EVCA. Daily cleanings were observed by at least one human factors engineer. Contextual enquiry with the EVCA post-observation was used to clarify issues.

    Results: We observed three EVCAs clean 19 rooms. Room cleanings lasted an average of 16.1 minutes, and 19 surfaces were cleaned per room. There were frequent interruptions, e.g. EVCA asked to leave the room by another healthcare worker (HCW) or asked to help a co-worker. Some surfaces were infrequently cleaned, such as the telephone which was cleaned only 21% of the time (see table for cleaning frequency of other surfaces). Upon contextual enquiry, EVCAs reported not cleaning items that were covered by patient belongings or in use by patients or other HCWs.

    Conclusion: Many surfaces in the patient room are not consistently cleaned. Frequent interruptions and inability to access the surfaces may contribute. These results will inform interviews and focus groups with EVCAs, the next step in this iterative HFE process.

    High touch surfaces

    No. of rooms where surface was cleaned (N=19)

    % of rooms where surface was cleaned

    Telephone

    4

    21%

    Cabinet

    5

    26%

    Side table

    7

    37%

    Call box/remote

    8

    42%

    Visitor chair

    10

    53%

    Grab bar

    10

    53%

    Main room light switch

    11

    58%

    Bathroom doorknob

    11

    58%

    Bed rails

    12

    63%

    Towel bar

    12

    63%

    Patient chair

    13

    68%

    Over bed table

    13

    68%

    Mouse

    13

    68%

    Bathroom light switch

    13

    68%

    Main room soap dispenser

    14

    74%

    Main room doorknob

    15

    79%

    Bathroom sink

    15

    79%

    Bathroom soap dispenser

    16

    84%

    Toilet seat

    17

    89%

    Keyboard

    17

    89%

    Main room sink

    18

    95%

    Flush handle

    18

    95%

    Supply cart*

    2

    100%

      *Supply cart was observed in 2 of the 19 rooms.

    Clare Rock, MD MS1, Heather Enos-Graves, MS2, Jennifer Andonian, MPH3, Sara Keller, MD, MPH, MSHP1, Sara Cosgrove, MD, MS, FIDSA, FSHEA1, Ayse Gurses, PhD MS MPH2, Anping Xie, PhD2 and the CDC Prevention Epicenter Program, (1)Department of Medicine, Division of Infectious Diseases, The Johns Hopkins University School of Medicine, Baltimore, MD, (2)Armstrong Institute for Patient Safety and Quality, Johns Hopkins University, Baltimore, MD, (3)Department of Hospital Epidemiology and Infection Control, The Johns Hopkins Hospital, Baltimore, MD

    Disclosures:

    C. Rock, None

    H. Enos-Graves, None

    J. Andonian, None

    S. Keller, None

    S. Cosgrove, None

    A. Gurses, None

    A. Xie, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.